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The intensive care medicine clinical research agenda in paediatrics

Peters, MJ; Argent, A; Festa, M; Leteurtre, S; Piva, J; Thompson, A; Willson, D; ... Lacroix, J; + view all (2017) The intensive care medicine clinical research agenda in paediatrics. Intensive Care Medicine , 43 (9) pp. 1210-1224. 10.1007/s00134-017-4729-9. Green open access

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Abstract

BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries. These registries allow detailed observational studies and feasibility testing of clinical trial protocols. Recent trials are larger and more valuable, and (2) most common interventions in PIC are not evidenced-based. Clinical studies for the next 10 years should address this deficit, including: ventilation techniques and interfaces; fluid, transfusion and feeding strategies; optimal targets for vital signs; multiple organ failure definitions, mechanisms and treatments; trauma, prevention and treatment; improving safety; comfort of the patient and their family; appropriate care in the face of medical complexity; defining post-PICU outcomes; and improving knowledge generation and adoption, with novel trial design and implementation strategies. The group specifically highlighted the need for research in resource-limited environments wherein mortality remains often tenfold higher than in well-resourced settings. CONCLUSIONS: Paediatric intensive care research has never been healthier, but many gaps in knowledge remain. We need to close these urgently. The impact of new knowledge will be greatest in resource-limited environments.

Type: Article
Title: The intensive care medicine clinical research agenda in paediatrics
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00134-017-4729-9
Publisher version: http://dx.doi.org/10.1007/s00134-017-4729-9
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Critical Care Medicine, Children, Critical care, Intensive care, Paediatrics, Research, CRITICALLY-ILL CHILDREN, RANDOMIZED CONTROLLED-TRIAL, ORGAN DYSFUNCTION SYNDROME, HOSPITAL CARDIAC-ARREST, TRAUMATIC BRAIN-INJURY, TIGHT GLYCEMIC CONTROL, SEPTIC SHOCK, CRITICAL ILLNESS, NEURODEVELOPMENTAL OUTCOMES, MONITORING SEVERITY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10048910
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